Author

Kierra Jones

Date of Award

Spring 2019

Document Type

Open Access Thesis

Department

Sociology

First Advisor

Carla A. Pfeffer

Abstract

Sex workers living with HIV are affected by pervasive stigma across various life domains because they are situated between two stigmatized identities—their HIV status and as someone who exchanges sexual services for pay. Prior research suggests that not only can stigma hinder attempts to initially access health care services, but it can also foster strained and unwelcoming environments. The purpose of the present study is to illuminate the voices and experiences of sex workers living with HIV as they navigate their specific health care needs. Using an intersectional lens, the aim of this study is to understand the health care experiences (i.e., decision making processes, navigation, and resources) of sex workers living with HIV, which may assist health researchers and practitioners in addressing the specific needs of this marginalized group. This is particularly important given that the current discourse surrounding HIV/AIDS in the United States largely centers “victories” and an “end of the epidemic.” A qualitative grounded theory approach is used to explore the experiences of sex workers living with HIV in accessing health care services and to explicate how they navigate these settings. I conducted six in-depth, semi-structured interviews with sex workers living with HIV (more interviews forthcoming). Participants indicated a need to address internalized stigma that exists within their respective communities, or at multiple community intersections (e.g. being part of both an LGBTQ and African-American community), as a way to introduce individuals into care and maintain it. In terms of health care navigation, all participants were already connected with a regular health care provider and on treatment regimens, making this a post hoc analysis of the initial introduction into care. Thematic findings demonstrate that part of a successful and sustained care regimen for sex workers living with HIV may require building special, often intimate bonds with health care providers as well as significant others in their lives. Findings also allude to the benefits of affirmative care promote individuals’ medical and life successes and encourage sex workers living with HIV to play an active role in their care. This research seeks to reinterpret existing knowledge on HIV as an ongoing social health problem by considering the diverse experiences of sex workers living with HIV and offering suggestions on how to improve the health and health care quality of sex workers living with HIV.

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